The success on EECP therapy can best be measured by the outcomes and benefits experienced by the patients undergoing the therapy. There are many factors that contribute to ensuring this success and perhaps one of the most important is the proper application of the therapy by trained personnel. The training of physicians and therapists responsible for the delivery of the therapy should include the following areas:

- Patient assessment – It is important to check the patient’s condition upon arriving for treatment to ensure that they are ready for treatment and there are no changes in their condition that would affect proper treatment.
Patient preparation - Ensuring that the patient is relaxed and prepared on the treatment table with the properly selected size cuffs is very important. It is very important to ensure that the bladders within the cuffs are properly sized and placed to ensure accurate delivery of pressures during the therapy. Only with proper wrapping of the cuffs can one assure the effective delivery of the selected pressures and timing. The patient’s skin must be prepared for the proper application of the electrodes that will produce a stable ECG, necessary to trigger the system’s inflate and deflate timing to the cardiac cycle. The next step is applying the finger plethysmograph probe that will produce the waveform upon which the therapist will depend on to ensure proper timing of the system for each individual patient.

- Inflation/deflation timing – Optimal therapy can only be achieved through the proper timing of inflation and deflation that will support effective counterpulsation. Effective couterpulsation may be best achieved when the EECP system delivers the desired pressure in accurate and timely synchronization with the heart’s cardiac cycle or rhythm, and not against it. Improper timing may cause erratic compression and decompression, which is very uncomfortable for the patient and may negatively affect the desired results.

- Proper pressures – Adequate treatment pressure is necessary to compress the blood vessels in the legs and buttocks. This enables better blood flow upon the decompression cycle. One must know the proper pressures recommended by the manufacturer of the EECP/ECP system, which may vary between manufacturers and even between different models of the same manufacturer. Published clinical trials demonstrated that standard and correctly delivered treatment pressures had better and longer lasting outcomes than patients treated at lower pressure.

Improper or ineffective delivery of EECP/ECP therapy treatment may not only negatively affect patient outcomes but may also affect any potential payer’s willingness to pay for the therapy and may actually hurt the reputation of EECP/ECP therapy with future prospective patients or referring physicians.

If you feel that your patient’s outcomes can be improved by additional training, it is suggested that you contact your EECP/ECP system’s manufacturer or your local distributor. In addition, you may contact the IEECPS directly at info@ieecps.org for any assistance or recommendations in obtaining additional clinical training.